Estimating risk of C. difficile transmission from PCR positive but cytotoxin negative cases

Background: The use of molecular methods to diagnose Clostridium difficile infection (CDI) has improved diagnostic yield compared to conventional methods. However, PCR testing can detect colonization and has introduced several practical challenges pertaining to need for treatment and isolation of cases. Methods: For all new cases detected by real-time PCR, concurrent cytotoxin assay was performed and genetic characterization with MLVA (multi-locus variable number tandem repeat analysis) was done to determine relatedness. We used PCR cycle threshold (Ct) of detection as surrogate marker for bacterial burden in stool. Results: Overall, 54 cases of CDI were detected during the study period. 42 were concurrently tested by CYT and characterized by MLVA. MLVA analysis revealed marked genetic diversity with no ongoing outbreaks; four cases were due to NAP1 strain. CYT-/PCR + cases had a higher median Ct value of detection compared to CYT+/PCR + cases (28.2 vs 22.5; p = 0.01). Among 25 strains that were genetically related, 9/11 isolates in this dominant cluster were positive by CYT compared to 4/14 in non-dominant clusters (p = 0.02). Conclusion: CYT-/PCR+ cases contribute to hospital based transmission. However, the risk of transmission of C. difficile from CYT +/PCR+ cases may be higher than those that are CYT-/PCR+. © 2014 Kamboj et al

Observation of High-Energy Astrophysical Neutrinos in Three Years of IceCube Data

A search for high-energy neutrinos interacting within the IceCube detector between 2010 and 2012 provided the first evidence for a high-energy neutrino flux of extraterrestrial origin. Results from an analysis using the same methods with a third year (2012-2013) of data from the complete IceCube detector are consistent with the previously reported astrophysical flux in the 100 TeV - PeV range at the level of $10^{-8}\, \mathrm{GeV}\, \mathrm{cm}^{-2}\, \mathrm{s}^{-1}\, \mathrm{sr}^{-1}$ per flavor and reject a purely atmospheric explanation for the combined 3-year data at $5.7 \sigma$. The data are consistent with expectations for equal fluxes of all three neutrino flavors and with isotropic arrival directions, suggesting either numerous or spatially extended sources. The three-year dataset, with a livetime of 988 days, contains a total of 37 neutrino candidate events with deposited energies ranging from 30 to 2000 TeV. The 2000 TeV event is the highest-energy neutrino interaction ever observed.Comment: 8 pages, 5 figures. Accepted by PRL. The event catalog, event displays, and other data tables are included after the final page of the article. Changed from the initial submission to reflect referee comments, expanding the section on atmospheric backgrounds, and fixes offsets of up to 0.9 seconds in reported event times. Address correspondence to: J. Feintzeig, C. Kopper, N. Whitehor

Search for Prompt Neutrino Emission from Gamma-Ray Bursts with IceCube

We present constraints derived from a search of four years of IceCube data for a prompt neutrino flux from gamma-ray bursts (GRBs). A single low-significance neutrino, compatible with the atmospheric neutrino background, was found in coincidence with one of the 506 observed bursts. Although GRBs have been proposed as candidate sources for ultra-high energy cosmic rays, our limits on the neutrino flux disfavor much of the parameter space for the latest models. We also find that no more than $\sim1\%$ of the recently observed astrophysical neutrino flux consists of prompt emission from GRBs that are potentially observable by existing satellites.Comment: 15 pages, 3 figure

Atmospheric and Astrophysical Neutrinos above 1 TeV Interacting in IceCube

The IceCube Neutrino Observatory was designed primarily to search for high-energy (TeV--PeV) neutrinos produced in distant astrophysical objects. A search for $\gtrsim 100$~TeV neutrinos interacting inside the instrumented volume has recently provided evidence for an isotropic flux of such neutrinos. At lower energies, IceCube collects large numbers of neutrinos from the weak decays of mesons in cosmic-ray air showers. Here we present the results of a search for neutrino interactions inside IceCube's instrumented volume between 1~TeV and 1~PeV in 641 days of data taken from 2010--2012, lowering the energy threshold for neutrinos from the southern sky below 10 TeV for the first time, far below the threshold of the previous high-energy analysis. Astrophysical neutrinos remain the dominant component in the southern sky down to 10 TeV. From these data we derive new constraints on the diffuse astrophysical neutrino spectrum, $\Phi_{\nu} = 2.06^{+0.4}_{-0.3} \times 10^{-18} \left({E_{\nu}}/{10^5 \,\, \rm{GeV}} \right)^{-2.46 \pm 0.12} {\rm {GeV^{-1} \, cm^{-2} \, sr^{-1} \, s^{-1}} }$, as well as the strongest upper limit yet on the flux of neutrinos from charmed-meson decay in the atmosphere, 1.52 times the benchmark theoretical prediction used in previous IceCube results at 90\% confidence.Comment: 18 pages, 12 figure

Search for a diffuse flux of astrophysical muon neutrinos with the IceCube 59-string configuration

A search for high-energy neutrinos was performed using data collected by the IceCube Neutrino Observatory from May 2009 to May 2010, when the array was running in its 59-string configuration. The data sample was optimized to contain muon neutrino induced events with a background contamination of atmospheric muons of less than 1%. These data, which are dominated by atmospheric neutrinos, are analyzed with a global likelihood fit to search for possible contributions of prompt atmospheric and astrophysical neutrinos, neither of which have yet been identified. Such signals are expected to follow a harder energy spectrum than conventional atmospheric neutrinos. In addition, the zenith angle distribution differs for astrophysical and atmospheric signals. A global fit of the reconstructed energies and directions of observed events is performed, including possible neutrino flux contributions for an astrophysical signal and atmospheric backgrounds as well as systematic uncertainties of the experiment and theoretical predictions. The best fit yields an astrophysical signal flux for nu(mu) + (nu) over bar (mu) of E-2. Phi(E) = 0.25 x 10(-8) GeV cm(-2) s(-1) sr(-1), and a zero prompt component. Although the sensitivity of this analysis for astrophysical neutrinos surpasses the Waxman and Bahcall upper bound, the experimental limit at 90% confidence level is a factor of 1.5 above at a flux of E-2 . Phi(E) = 1.44 x 10(-8) GeV cm(-2) s(-1) sr(-1)

Measurement of the Atmospheric νe\nu_e Spectrum with IceCube

We present a measurement of the atmospheric $\nu_e$ spectrum at energies between 0.1 TeV and 100 TeV using data from the first year of the complete IceCube detector. Atmospheric $\nu_e$ originate mainly from the decays of kaons produced in cosmic-ray air showers. This analysis selects 1078 fully contained events in 332 days of livetime, then identifies those consistent with particle showers. A likelihood analysis with improved event selection extends our previous measurement of the conventional $\nu_e$ fluxes to higher energies. The data constrain the conventional $\nu_e$ flux to be $1.3^{+0.4}_{-0.3}$ times a baseline prediction from a Honda's calculation, including the knee of the cosmic-ray spectrum. A fit to the kaon contribution ($\xi$) to the neutrino flux finds a kaon component that is $\xi =1.3^{+0.5}_{-0.4}$ times the baseline value. The fitted/measured prompt neutrino flux from charmed hadron decays strongly depends on the assumed astrophysical flux and shape. If the astrophysical component follows a power law, the result for the prompt flux is $0.0^{+3.0}_{-0.0}$ times a calculated flux based on the work by Enberg, Reno and Sarcevic.Comment: PRD accepted versio

No Sex Differences in Inflammatory Response and Vascular Function During Low Estrogen Phase

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High-Power Quantum-Limited Photodiode and Classical Laser Noise Squashing

To benefit high-power interferometry and the creation of low-noise light sources, we develop a simple lead-compensated photodetector enabling quantum-limited readout from 0.3 mW to 10 mW and 10 k$\Omega$ transimpedance gain from 85 Hz - 35 MHz. Feeding the detector output back to an intensity modulator, we squash the classical amplitude noise of a commercial 1550 nm fiber laser to the shot noise limit over a bandwidth of 700 Hz - 200 kHz, observing no degradation to its (nominally ~100 Hz) linewidth.Comment: 7 pages, 6 figure

Retaining young people in a longitudinal sexual health survey: a trial of strategies to maintain participation

Background: There is an increasing trend towards lower participation in questionnaire surveys. This reduces representativeness, increases costs and introduces particular challenges to longitudinal surveys, as researchers have to use complex statistical techniques which attempt to address attrition. This paper describes a trial of incentives to retain longitudinal survey cohorts from ages 16 to 20, to question them on the sensitive topic of sexual health.Methods: A longitudinal survey was conducted with 8,430 eligible pupils from two sequential year groups from 25 Scottish schools. Wave 1 (14 years) and Wave 2 (16 years) were conducted largely within schools. For Wave 3 (18 years), when everyone had left school, the sample was split into 4 groups that were balanced across predictors of survey participation: 1) no incentive; 2) chance of winning one of twenty-five vouchers worth 20; pound 3) chance of winning one 500 pound voucher; 4) a definite reward of a 10 pound voucher sent on receipt of their completed questionnaire. Outcomes were participation at Wave 3 and two years later at Wave 4. Analysis used logistic regression and adjusted for clustering at school level.Results: The only condition that had a significant and beneficial impact for pupils was to offer a definite reward for participation (Group 4). Forty-one percent of Group 4 participated in Wave 3 versus 27% or less for Groups 1 to 3. At Wave 4, 35% of Group 4 took part versus 25% or less for the other groups. Similarly, 22% of Group 4 participated in all four Waves of the longitudinal study, whereas for the other three groups it was 16% or less that participated in full.Conclusions: The best strategy for retaining all groups of pupils and one that improved retention at both age 18 and age 20 was to offer a definite reward for participation. This is expensive, however, given the many benefits of retaining a longitudinal sample, we recommend inclusion of this as a research cost for cohort and other repeat-contact studies